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OCCUPATIONAL RESPIRATORY DISEASES
By: Gh. Pouryaghoub. MDCenter for Research on Occupational Diseases (CROD)Tehran University of Medical Sciences (TUMS)
Anatomy
Upper respiratory tract: nasal passages pharynx and associated structures
Lower respiratory tract: Larynx Trachea Bronchi Bronchioles alveolar ducts and alveoli
Anatomy (Functional)
CONDUCTING PORTION
nasal passages all the way down to terminal bronchioles
TRANSITIONAL & RESPIRATORY PORTION
respiratory bronchioles, alveolar ducts and alveoli
Respiratory System Functions
1. ventilation2. Air conditioning3. Gas exchange4. Phonation5. Contains receptors for smell6. Rids the body of some excess water and heat7. Acid-base balance8. Pulmonary defense9. Metabolism and handling of bioactive materials
Toxic Inhalation by Ventilation
Gases
Vapors
Aerosols Dust
Mist
Fog
Fume
Smoke
TOXIC EFFECTS
Dust properties
Site of action
Duration and intensity
Defense mechanisms
Personal factors
ANATOMIC SITES
Particle size
Geometry
Surface area
Inertia
Electrostatic Charge
Coagulability
Hygroscopy
Solubility
ACUTE RESPIRATORY RESPONSES TO TOXINES
Rhinosinositis
Laryngitis
Airway obstruction
Bronchitis
Alveolitis
Pulmonary edema
CHRONIC RESPIRATORY RESPONSES TO TOXINES
Asthma
Bronchitis
Parenchymal fibrosis
Pleural fibrosis
Cancer
OCCUPATIONAL LUNG DESEASES
Asthma
Pneumoconiosis
Silicosis
Asbestosis
OCCUPATIONAL ASTHMA
Definition
Etiologic and Predisposing factors
Diagnosis
Treatment
Prevention
PNEUMOCONIOSIS
BENIGNIron oxideTinBariumAntimonyZirconiumTitanium
COLLAGENOUSSilicaAsbestosCoal dustTalkBerylliumAluminum
SILICOSIS
CHRONIC or CLASSICAL
ACCELERATED
ACUTE
Exposure to free crystalline silica
OCCUPATIONAL EXPOSUER
Foundry
Mining, Tunneling
Abrasives, Sand blasting
Stone cutting, Polishing
Glass manufacturing
Ceramics
SILICOSIS
High mortality and morbidity
Preventable by avoidance of exposure
Medical surveillance is one of the main parts of its primary prevention
WHO and ILO joint program
"International Program on Global Elimination of Silicosis“ (since 1995)
One of the main parts of this program is the formulation of national and regional action plans
Diagnostic Criteria
Based on physician potential experience & knowledge and the following criteria
History of significant exposure to silica dust AND
A chest X-ray compatible with silicosis AND
Rule out other diseases that may mimic silicosis
ASBESTOSIS
Inflammatory granulomatous reactions to asbestos over the course of years
Fiber cement productionInsulation and fire proofingReinforced plasticsTextilesPaperFilter